A touchy topic: tactile assessment among pediatric therapists

Abstract

Purpose: Tactile impairments affect over 77% of children with unilateral cerebral palsy (CP). This study aimed to examine the current practices of pediatric therapists in relation to tactile assessment and the barriers to carrying out tactile assessment in children with CP.Method: The study was in two parts. In part one, pediatric therapists (n = 35) completed a questionnaire detailing their current knowledge and the use of tactile assessments in children. In part two, therapists (n = 12) completed a questionnaire based on the Theoretical Domains Framework examining the barriers and facilitators to completing tactile assessments in clinical practice.Results: Most therapists (over 90%) carry out tactile assessments in the minority (less than 25%) of children with CP that they treat. Therapists reported the need for improved knowledge/skills (n = 24) and confidence (n = 19) in carrying out tactile assessments, alongside the provision of necessary equipment (n = 17). Qualitative reports also suggested that organizational assessment guidelines and templates may facilitate the implementation of tactile assessment.Conclusions: A multi-faceted knowledge translation strategy to address the barriers to tactile assessment among pediatric therapists needs to be developed.Implications for rehabilitationPediatric occupational therapists and physiotherapists may not be completing tactile assessments according to current evidence-based recommendations.Therapists identified five main barriers, including a lack of knowledge, skills, belief in their capabilities (confidence), behavioral regulation (organizational procedures), and environmental context (e.g., equipment).Therapists recommended several potential facilitators, including access to necessary equipment, procedures, record sheets, training in tactile assessments, and research supporting related interventions.Service providers are encouraged to develop multi-faceted knowledge translation strategies that address these barriers and maximize facilitators.